A treatise on orthopedic surgery . to the calf band (). Arthrodesis. —I n thisclass of cases in which theanterior muscles are com-pletely paralyzed the oper-ation of arthrodesis for thepurpose of fixing the footat a right angle with theleg is of value in laterchildhood. In most in-stances the mediotarsal aswell as the ankle-jointmust be operated on. Un-der the Esmarch bandagethe two joints are openedby an incision in the cen-tre of the foot, beginningabout one inch above the ankle-joint and extending downwardfor about three inches. The cartilaginous surfaces of the astrag-alus and leg b
A treatise on orthopedic surgery . to the calf band (). Arthrodesis. —I n thisclass of cases in which theanterior muscles are com-pletely paralyzed the oper-ation of arthrodesis for thepurpose of fixing the footat a right angle with theleg is of value in laterchildhood. In most in-stances the mediotarsal aswell as the ankle-jointmust be operated on. Un-der the Esmarch bandagethe two joints are openedby an incision in the cen-tre of the foot, beginningabout one inch above the ankle-joint and extending downwardfor about three inches. The cartilaginous surfaces of the astrag-alus and leg bones may be removed with a narrow-bladed knifeor thin, sharp chisel, while the foot is held in plantar the mediotarsal joint a thin, wedge-shaped section, base up-ward, including the astragalonavicular and calcaneocuboidjoints, may be removed also in order to prevent the subsequentsinking of the forefoot. The ankle joint can be more com-pletely exposed by the external lateral incision as describedunder The same appliance (Fig. 527) providedwith a foot plate of metal or of wood asshown in the diagram. This modificationis useful if the paralysis is complete or ifthe foot is much atrophied. DEFOEMITIES OF TEE FOOT. 857 If there is restriction of dorsal flexion the foot should heforced up to a right angle with the leg against the resistance ofthe tendo Achillis, thus pressing the denuded surfaces other instances silk sutures may he passed through the peri-osteum of the opposing bones. The wound is then closed withcatg-ut ligatures and a plaster-of-Paris bandage is applied tohold the foot at a right angle with the leg. Operations of thischaracter on the bones are sometimes followed by swelling. Onthis account the bandage should be applied over a thick layer of Fig. 581.
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Keywords: ., bookauthorwhitmanr, bookcentury1900, bookdecade1910, bookyear1910
